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由于茶碱有效血清浓度范围窄,血浆清除率受多种因素影响,使得茶碱的应用颇为棘手。即使是有效血清浓度,病人也可感受到茶碱的毒性作用。当血浓度升至20μg/ml以上时,毒副作用更常见。为了辨认对茶碱毒性有高度危险的病人,作者复习了1987年间214例住院病人的510次高血清茶碱浓度(>20μg/ml),调查这些病人出现危及生命事件的发生率。 214例病人中,97例出现一次毒性作用的血浓度,117例出现多次毒性作用的血浓度。114例次(22％)高血清茶碱浓度伴有恶心、呕吐、腹痛。烦燥不安13例次,震颤19例次,幻觉4例次,头痛23例次,但无一例病人表现为茶碱毒性作用有关的精神病。50例次高血清茶碱浓度见于曾有癫痫病史
Due to the narrow range of effective theophylline serum concentrations, plasma clearance affected by many factors, making the theophylline application is quite tricky. Even if the effective serum concentration, the patient can feel the toxic effects of theophylline. Toxic side effects are more common when blood levels rise above 20 μg / ml. To identify patients at high risk of theophylline toxicity, the authors reviewed 510 high serum theophylline concentrations (> 20 μg / ml) in 214 hospitalized patients in 1987 and investigated the incidence of life-threatening events in these patients. Of the 214 patients, 97 had a toxic blood concentration and 117 had multiple toxicities. 114 cases (22%) of high serum theophylline concentration associated with nausea, vomiting, abdominal pain. 13 cases of irritability, 19 cases of tremor, 4 cases of hallucinations and 23 cases of headache, but none of the patients showed psychosis related to theophylline toxicity. 50 cases of serum hypophyseal concentration seen in the history of epilepsy